Organization
MIDTOWNE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIM MULDER (CEO)
(616) 827-9100
Entity
Organization
Contact information
Practice address
555 MIDTOWNE ST NE, SUITE 103, GRAND RAPIDS, MI 49503-5729
(616) 554-1964
Mailing address
555 MIDTOWNE ST NE, SUITE 103, GRAND RAPIDS, MI 49503-5729
(616) 554-1964
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009298
MI
Other
Enumeration date
04/13/2010
Last updated
07/30/2010
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